Protection of risk groups: discussing Tübingen is silly

Rather than seriously looking at which Tübingen measures to protect old people’s homes are transferable to other regions and which are not, there is a discussion about whether the city is doing everything right and everyone else is wrong. But that is neither appropriate nor convenient.

Tübingen made headlines because the city has taken decisive steps to protect its nursing homes and nursing homes. That is really positive and one could hope that other municipalities or even federal states will take a closer look at what the city of Swabia is doing well, to possibly take an example from it. Many probably do too. But the success of Tübingen is also fueling a strange dispute over the direction in which it seems that it is less about how to overcome the pandemic better than who is right. This makes no sense because no one can know exactly what is right or possible at this point. And anyway, one option is out of place.

One of the reasons for the irrational discussion about Tübingen is its mayor Boris Palmer (Greens), who is even a hot topic in his own party because he is so convinced of himself and has already made some missteps in his career. Among other things, he has a problem with the capital, in which he feels uncomfortable because “he cannot cope with this mixture of crime, drug trafficking and abject poverty on the street as a bourgeois green plant of Baden-Württemberg.”

Tübingen really can do it

And someone like that comes up and explains to the rest of Germany how easy it is to protect risk groups if you just want to. But that’s also true, at least for its quiet and orderly Tübingen. Staff in fixed and mobile geriatric care have been regularly tested since September. A PCR test is performed twice a week, and every three to seven days there is a rapid test that is also available to home visitors. So far this has been voluntary for guests, but Palmer is examining the requirement to test.

Seniors can take a taxi for the price of a bus ticket to run important errands or a visit to the doctor, so they don’t have to rely on public transportation. Additionally, Tübingen’s younger residents must allow older residents to shop between 9:30 a.m. and 11 a.m. Lastly, the city is distributing free FFP2 masks to those 65 and older.

It’s doubtful that the strategy grew just on Palmer’s nonsense. Tübingen district administrator Joachim Walter (CDU) told “FAZ” that the district had systematically carried out corona tests on homes in April. Also, this was the brainchild of Tübingen ER doctor Lisa Federle. She not only campaigned for independent nursing home symptom testing, but she also drove around town on a test mobile and purchased rapid nursing home tests a few weeks ago when the state government had yet to recognize the need to act. , according to the “FAZ”.

Federle has also started the rapid test station in Tübingen’s town hall square, which aims to make Christmas visits to the elderly safer with test campaigns on 23 and 24 December. The same should happen in 25 other cities in Baden-Württemberg.

Higher incidence among people over 80 years of age

Either way, it is absolutely okay to provide special protection for nursing homes and retirement homes. Because 85 percent of Covid 19 victims in Germany are over 69 years old, on average 82 years old. An RKI assessment of the first corona wave showed that nearly one in every second case among those over the age of 80 was hospitalized and one in three Covid 19 patients in this age group succumbed to the disease.

According to RKI’s management report on December 9, the partial closure never led to a decrease in the incidence of older people. On the contrary, they have continued to increase, and in no other age group are there as many infections per week and 100,000 inhabitants as among those over 80 years of age. And the RKI also claims that there are many Covid-19 infections and deaths in care facilities.

Obviously, nursing homes and old people’s homes are not yet effectively protected in Germany. New outbreaks and deaths are reported daily at such facilities. Things are looking bad in Berlin, for example. From mid-November to early December, according to RBB, the number of new infections among residents of nursing homes in the capital has doubled since mid-November. Most recently, 55 residents and 13 employees tested positive at a retirement home in Berlin-Friedrichshain on Wednesday. In the Prenzlauer Berg district there has so far been one death following an outbreak in a pen.

There are still too many outbreaks in nursing homes

But the corona virus continues to ravage other parts of Germany, especially in the care centers. In the Bavarian district of Traunstein, six residents died after an outbreak in a house. According to “Passauer Neue Presse”, 36 residents and 20 employees have recently tested positive at two other facilities. In Neckargemünd, the coronavirus broke out in a nursing home on November 20, since then, according to the “Rhein-Neckar-Zeitung”, 13 of the 90 infected residents have died. The “Hessenschau” reported that around three-quarters of corona deaths in Hesse came from healthcare facilities.

The federal government’s new test strategy has been in effect since October 15. “Nursing homes and hospitals can make generous use of rapid antigen tests to periodically screen staff, visitors, patients and residents for coronavirus,” explains the Ministry of Health. But obviously this still doesn’t work properly.

One reason is bureaucracy. Because nursing homes and other health care facilities must submit a trial concept to the responsible health department according to the trial regulation. Up to 20 tests per resident per month are possible. However, the institutions must take care of the recruitment. And then, according to ARD and “Süddeutsche Zeitung”, they often have to wait a long time to get approval.

Who should do the tests?

Probably an even bigger problem is the chronic shortage of staff that many care facilities already suffer from. The “BR” reported that the mandatory testing in nursing homes, which has been in force in Bavaria since Wednesday, was totally overwhelming. All visitors must be screened, staff twice a week.

Because there are simply no employees for this, the new regulation leads to a de facto ban on visits, a Caritas official said. Ask for support from aid organizations or the military. The Bavarian Ministry of Health informed the BR that they were working “at full speed”.

The situation is probably similar in many states and federal cities. Often times, the protection of nursing homes and nursing homes is only being seriously addressed now or recently. However, implementation often falls by the wayside due to understaffing or other capacity limits.

Two new positions for staff only

For example, Berlin only launched a website with questions and answers on dealing with rapid tests in nursing homes on December 1. And just on Wednesday, the RBB reported on a joint position document of the Senate, doctors, hospitals and associations. Among other things, people in need of care must be randomly tested and staff must be tested twice a week.

Was there also thought of additional staff, so that in the capital it does not grow on trees? Even in Boris Palmer’s homeland, things are not looking good in this regard. Baden-Württemberg has strong “Latest news from Baden“It ordered five million rapid tests for its nursing homes. However, a spokeswoman for the Ministry of Health told the newspaper that an average facility would need an additional staff position or two to screen employees only twice a week.

Unfair accusations

Of course, you have to ask the states and federal districts why they did not start protective measures for old people’s and retirement homes much earlier, like Tübingen. But postcards are of no use in the current crisis situation. Likewise, the accusations against the Society for Virology, which includes Christian Drosten and Sandra Cisek, are equally futile.

So shared his colleague Jonas Schmidt-Chanasit published a thread on Twitter stating that society has explicitly spoken out against the protection of risk groups. This is justified by an extract from a statement from the society in which it effectively says that it rejects a strategy that provides for the use of special protection measures to mitigate morbidity and mortality in vulnerable groups. However, the author omits the fact that the opinion refers to the rejection of a strategy to combat pandemics that aims at natural contamination of large sectors of the population with the objective of herd immunity.

Also Palmer for hard blocking

This is not clean, nor is it an appropriate procedure if you want to celebrate Boris Palmer for “his” crown strategy. Because the mayor of Tübingen also said yesterday in “Maybrit Illner” that he now no longer sees any alternative to the blockade, the figures are simply too high. It even suggests that he considered the partial block to be too mild and therefore inappropriate from the start. And Palmer has no problem with bans, either. Because citizens had abused their freedoms, he only had to order an alcohol ban, he said.

In an interview with the “Fuldaer Zeitung”, Palmer specified that he had a harsh two-week lockdown during the Christmas holidays. “That would probably mean that the January figures would be so depressed that one could return to normal behavior until at least February.” However, he expects an early effect of vaccines and assumes that the health system can cope with a condition exceeding 100 for a longer period of time. Many experts assume that a lockdown would have to last at least four weeks and do not think that the health emergency has already been avoided, as Palmer says in an interview.

Some things are understandable, some are not

In any case, there is not one or the other. Palmer not only wants to protect risk groups, but he also wants to reduce the number of new infections. It is probably correct that the crashes could have been avoided if “intensive contact tracing” had been carried out. On the other hand, the notion that you only need to increase the capacity of health authorities to control an incidence of 100 is quite naive.

Tübingen does a lot of things well, but that doesn’t necessarily make it a model for the rest of the country. Other cities can take over some of them one by one, others have to adapt or find alternatives. The city of Swabia with 91,000 inhabitants, where the largest employers are the university and the clinic, can hardly be compared to metropolises like Berlin or other metropolitan areas. Similarly, you cannot simply transfer a city’s measures to the state level or even turn them into federal policy.